# metadata.dc.description.abstract[].value
Backgound: In recent years we have witnessed an increase in infections due to multidrug-resistant
organisms in kidney transplant recipients (KTR). In our setting, we have observed a dramatic increase in
infections caused by extended-spectrum betalactamase-producing (ESBL) Enterobacteriaceae in KTR. In 2014
we changed surgical prophylaxis from Cefazolin 2 g to Ertapenem 1 g.
Methods: We compared bacterial infections and their resistance phenotype during the first post-transplant
month with an historical cohort collected during 2013 that had received Cefazolin.
Results: During the study period 110 patients received prophylaxis with Cefazolin and 113 with Ertapenem.
In the Ertapenem cohort we observed a non-statistically significant decrease in the percentage of early
bacterial infection from 57 to 47%, with urine being the most frequent source in both. The frequency of
infections caused by Enterobacteriaceae spp. decreased from 64% in the Cefazolin cohort to 36% in the
Ertapenem cohort (p = 0.005). In addition, percentage of ESBL-producing strains decreased from 21 to 8% of
all Enterobacteriaceae isolated (p = 0.015). After adjusted in multivariate Cox regression analysis, male sex (HR
0.16, 95%CI: 0.03–0.75), cefazolin prophylaxis (HR 4.7, 95% CI: 1.1–22.6) and acute rejection (HR 14.5, 95% CI:
1.3–162) were associated to ESBL- producing Enterobacteriaceae infection.
Conclusions: Perioperative antimicrobial prophylaxis with a single dose of Ertapenem in kidney transplant
recipients reduced the incidence of early infections due to ESBL-producing Enterobacteriaceae without
increasing the incidence of other multidrug-resistant microorganisms or C. difficile.

# metadata.dc.source[].value
Articles publicats en revistes (Medicina)